Orthopedics Commons^™

Opioid Free Anesthesia In Arthroscopic Knee Surgery: A Feasible Approach To Patient Care, Carson Gifford, Denise Vidal, Dail Kim, Austin Goff, Paul Reynolds

HCA Healthcare Journal of Medicine

Background

The opioid epidemic has prompted exploration of opioid-free anesthesia (OFA) techniques, but the optimal approach is still debated. While some OFA protocols substitute opioids with other agents, these alternatives can introduce their own risks. The objective of this study was to investigate whether eliminating intraoperative opioids without analgesic substitution in arthroscopic knee procedures affects postoperative pain control and opioid requirements.

Methods

We conducted a retrospective analysis of 205 patients who underwent arthroscopic knee procedures between August and November 2023. Patients were divided into 2 groups: those who received intraoperative fentanyl (25-200 mcg, n = 144) and those who received …

Stemless Arthroplasty For Avascular Necrosis Of The Humerus: Implant Survival And Outcomes, Alyssa R. Henriquez, Damon V. Briggs, Eoghan T. Hurley, Samuel Lorentz, Christopher S. Klifto, Michael A. Moverman, Oke Anakwenze

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Avascular necrosis (AVN) of the humeral head often affects younger patients and may lead to progressive pain and functional deficits. While stemmed hemiarthroplasty and total shoulder arthroplasty (TSA) are established treatments for advanced-stage AVN, stemless arthroplasty offers potential advantages including bone preservation and facilitation of future revision. However, the impact of bone necrosis on stemless humerus fixation is yet to be elucidated. Therefore, the purpose of this study was to evaluate the outcomes of stemless hemiarthroplasty and TSA in treating humeral head AVN and, further, to determine if stemless humeral fixation is appropriate in this population.

METHODS: This retrospective …

Predictive Factors For Humeral And Ulnar Stem Loosening After Total Elbow Arthroplasty: A Retrospective Cohort Study, Akash Singh, James Satalich, Miguel Fiandeiro, Harrison S. Fellheimer, Matthew Ramsey, Surena Namdari

Rothman Institute Conference Posters

BACKGROUND: There has been a significant increase in the use of total elbow arthroplasty (TEA) in advanced osteoarthritis, post-traumatic arthritis, and complex distal humerus fractures. The purpose of this study is to determine the incidence of total elbow loosening and association with patient demographics, implant specifications, and cement mantle characteristics.

METHODS: A retrospective cohort study was conducted of patients who underwent primary TEA between 2013 and 2022 at a single institution. Revisions and conversions from prior open reduction and internal fixation were excluded. Pre-operative distal humeral cortical thickness and bone quality were assessed. Variables included anterior humeral flange contact with …

Intravenous Versus Oral Tranexamic Acid In Shoulder Arthroplasty, Tarishi Parmar, Akin Adio, Mohammad Daher, Adam Khan, John Horneff, Joseph A. Abboud

Rothman Institute Papers

PURPOSE: Tranexamic acid (TXA) is used in shoulder arthroplasty to reduce blood loss. While intravenous (IV) TXA is standard, oral TXA offers advantages in cost and administration. This study compares 90-day complications and postoperative laboratory values between IV and oral TXA in total shoulder arthroplasty (TSA).

METHODS: A retrospective cohort study using TriNetX identified adults undergoing primary TSA (2005-2025) receiving TXA on the day of surgery, stratified by route (IV vs. oral). One-to-one propensity score matching was performed. Ninety-day outcomes included transfusion, thromboembolic events, cardiac and renal complications, neurologic events, infection, wound dehiscence, readmissions, emergency department visits, opioid utilization, and …

Population-Level Eligibility For Bonemri As A Radiation-Free Alternative To Spine Ct, Niels Levy-Thiebaut, Timothy Borden Md

Summer Research Program Abstracts

No abstract provided.

Non-Tobacco Nicotine Dependence Is Associated With Increased Complications Following Clavicle Open Reduction Internal Fixation, Akin A. Adio, Rahul K. Goyal, Abby Skiena, Mohammad Daher, John G. Horneff, Hafiz F. Kassam, Brian W. Hill, Joseph A. Abboud

Rothman Institute Papers

BACKGROUND: Tobacco dependence is well established to impair bone healing and increase postoperative complications. However, the independent effects of nicotine, separate from combustion-related factors, remain unclear. This study aimed to evaluate the impact of non-tobacco nicotine dependence (NTND) following open reduction and internal fixation (ORIF) of clavicle fractures, including midshaft and lateral fracture subtypes.

METHODS: A retrospective cohort study was performed using a large national database. Patients undergoing ORIF of clavicle fractures were identified using procedural and diagnostic codes. Patients with non-tobacco nicotine dependence (e.g., vaping, patches, or gum) were identified and propensity score matched to (1) patients without nicotine …

Intraoperative Liposomal Bupivacaine Is Associated With Reduced Opioid Use And Enhanced Recovery After Total Knee Arthroplasty: A Multicenter Registry Study, Mitchell Ng, Jennifer Lin, Andrew Spitzer, Vinod Dasa, Adam Rivadeneyra, David Rogenmoser, Andrew Concoff, Mary Digiorgi, Joshua Urban, William Mihalko, Michael Mont

Rothman Institute Papers

BACKGROUND: With an annual volume of total knee arthroplasties (TKAs) in the United States projected to exceed 1.5 million by 2050, optimizing perioperative pain control and facilitating early discharge remain clinical priorities. This study evaluated the effectiveness of liposomal bupivacaine (LB) vs conventional bupivacaine/ropivacaine in opioid-naïve patients undergoing primary TKA, comparing/contrasting: (1) pain score improvements, (2) opioid usages, (3) functional recoveries, and (4) hospital lengths of stay.

METHODS:  Data from the Innovations in Genicular Outcomes Research (iGOR) registry were used to identify patients undergoing unilateral primary TKA between September 2021 and December 2024. Two hundred twenty-five patients were analyzed, 42 …

Pre-Operative Antiplatelet Therapy Is Associated With Increased Risk Of Periprosthetic Joint Infection Following Total Shoulder Arthroplasty, Muhammad Hamza Ilyas, Mohammad Daher, Viraj Deshpande, Adam Lindsay, Joseph A. Abboud, Hafiz F. Kassam

Rothman Institute Papers

Background Antiplatelet therapy is widely prescribed for the prevention and management of cardiovascular disease and for mitigation of thromboembolic risk. However, its impact on post-operative periprosthetic joint infection (PJI) following total shoulder arthroplasty (TSA) remains poorly defined.MethodsA retrospective cohort study was conducted using the TriNetX US Research Network. Propensity score matching was performed to balance demographics, body mass index, and Charlson Comorbidity Index variables. The primary outcome was the incidence of PJI at 90 days, 6 months, and 1 year. Secondary outcomes included post-operative medical and surgical complications. Comparative risk was quantified using risk ratios with 95% confidence intervals. Subgroup …

Increasing Utilization Trends Of Robotic Assistance In Orthopaedic Surgery, Anish K. Ponna, Alec Giakas, Anthony A. Khoudary, Spencer N. Uggla, Sina Ramtin, Yousef A. Soliman, Asif M. Ilyas

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Robotic-assisted surgeries in orthopaedics have increased, particularly in hip and knee arthroplasty and spine surgeries. This study evaluates national utilization trends of robotic-assisted orthopaedic surgeries and demographic and geographic distribution of patients undergoing these surgeries.

METHODS: A retrospective cohort study was conducted on patients who underwent total hip arthroplasty, total and partial knee arthroplasty, or spine arthrodesis from 2017 to 2023 using the TriNetX database. Relevant International Classification of Diseases, 10th Revision, and Current Procedural Terminology codes identified patients who underwent a primary surgery with a corresponding robot-assisted code on the same day. Temporal trends in procedural volume were …

Elixhauser Comorbidity Index To Predict Perioperative Bleeding And Adverse Spine Surgery Outcomes, Mitchell K. Ng, Michael A. Mont, Mosadoluwa Afolabi, Prathiksha N V, Amitha Kumar, Stephen S. Johnston

Rothman Institute Papers

Introduction: As spine surgery volume continues to grow, ensuring patient safety and minimizing complications are increasingly critical. Disruptive bleeding—defined as hemorrhagic events requiring clinical intervention—is a significant perioperative challenge. This study aimed to: (1) quantify disruptive bleeding incidence; (2) evaluate associations between patient demographics, Elixhauser Comorbidity Index (ECI), and bleeding risk; and (3) assess the impact of disruptive bleeding on mortality, ventilator use, length of inpatient stay, 90-day readmissions, and inpatient costs. Methods: A nationwide healthcare database was used to identify patients who underwent spine surgery in 2019. Patients were subdivided by the Elixhauser Comorbidity Index (ECI) from 0 to …

Reliability Of Existing Measures And Classification Systems For Trochlear Dysplasia, Sean R. Waldron, Nihar S. Shah, Matthew W. Veerkamp, Brendan A. Williams, John A. Schlechter, Lauren H. Redler, Matthew D. Ellington, Shital N. Parikh

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Patellofemoral instability (PFI) is common in adolescent patients and can lead to a reduction in quality of life and function, as well as long-term arthritis. Treatment of PFI involves assessing and, at times, surgically correcting underlying anatomic abnormalities. Trochlear dysplasia is the most common anatomic risk factor present in PFI.

PURPOSE: To determine the interrater reliability of existing measures and classification systems for the assessment of trochlear dysplasia.

STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3.

METHODS: As part of the PRISM (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) patellar instability Research Interest Group (RIG) project, a …

How Does Pattern Of Bone Healing Affect The Strain Of Plate Implant Via Frequency Detection? A Biomechanical Cadaveric Study, Chavarin Amarase, Chanyaphan Virulsri, Pairat Tangpornprasert, Pisitpong Chancharoen, Saran Tantavisut

Chulalongkorn Medical Journal

Background: Detecting bone union is a crucial process in treating bone fractures to prevent complications, including implant failure and bone nonunion. Nowadays, there are many methods and new innovative devices for detecting bone union through strain measurements, such as strain gauges, fluid level displacement, contrast media, and frequency changes. There is also a trend toward increasing these methods in the future. However, the patterns of bone healing studied with these methods still do not provide a standard for determining the true bone healing process. The aim of this study is to identify the most appropriate bone healing pattern for …

Elbow Ulnar Collateral Ligament Reconstruction And Repair: A Systematic Review And Meta-Analysis Of Biomechanical Studies, Austin Looney, Adeeb Hanna, Carlo Coadonato, John Sonnier, Blake Bodendorfer, Christopher Anderson, Neil Sarna, Kevin Freedman, Michael G. Ciccotti, Michael C. Ciccotti, Brandon Erickson, Steven Cohen

Rothman Institute Papers

BACKGROUND: Technical variations in elbow ulnar collateral ligament reconstruction (UCLR) include graft source, graft/tunnel configuration, and humeral and ulnar fixation. While the biomechanical performance of various constructs has been reported, these studies have small sample sizes and compare at most a few technical variations.

PURPOSE: To quantitatively synthesize the results of biomechanical investigations of UCLR and repair.

STUDY DESIGN: Systematic review.

METHODS: A systematic review and meta-analysis was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses); included articles were published between 1998 and 2020. Biomechanical metrics were utilized to compute effect sizes (standardized mean difference [SMD]) …

Repair Techniques For Acute Rupture Of The Patellar Tendon: A Systematic Review, Gaston Davis, Harrison S. Fellheimer, Christian Mccormick, Kevin B. Freedman

Rothman Institute Papers

BACKGROUND: Multiple techniques exist to repair acute tears of the patellar tendon. Surgical repair is required to reestablish full function of the extensor mechanism of the knee, and optimal results typically occur when the tear is repaired acutely.

PURPOSE: To systematically review the literature to evaluate treatment outcomes and complication rates after acute surgical repair of patellar tendon ruptures using suture anchor repair, transosseous repair, and end-to-end repair.

STUDY DESIGN: Scoping review; Level of evidence, 4.

METHODS: A systematic review was performed to analyze outcomes after patellar tendon repair in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews …

Effects Of Glucagon-Like-Peptide-1 Receptor Agonists (Glp-1a) Medications In Patients Undergoing Total Hip Arthroplasty (Tha): A Systematic Review And Meta-Analysis, Tanner Haechten, Troy B. Puga, Vincent Dieu, Mckenna W. Box, Kyle O'Connor, John T. Riehl

North Texas GME Research Forum 2026

Background Glucagon-Like-Peptide-1 Receptor Agonists (GLP-1a) medications have rapidly grown in popularity, however, their effects on the outcomes of Total Hip Arthroplasty (THA) remain largely unclear. The objective of this systematic review and meta-analysis is to evaluate the outcomes of patients undergoing THA and using a GLP-1a medication. Methods A search was conducted across six databases. The search used a combination of keywords and Medical Subject Heading (MeSH) terms. Titles and abstracts were screened for eligibility for inclusion criteria. Full texts were screened and included if they met eligibility criteria. Demographics and results of the studies were extracted from included articles. …

Outcomes Of Total Knee Arthroplasty (Tka) In Patients On Glucagon-Like-Peptide-1 Receptor Agonists (Glp-1a): A Systematic Review And Meta-Analysis, Lachlan Anderson, Troy B. Puga, Erica Olfson, Kyle P. O'Connor, Mckenna W. Box, John T. Riehl

North Texas GME Research Forum 2026

Introduction Glucagon-Like-Peptide-1 Receptor Agonist (GLP-1a) medications are commonly prescribed to treat diabetes and obesity, however, their effects on the outcomes of Total Knee Arthroplasty (TKA) remain largely unclear. The objective of this systematic review and meta-analysis is to evaluate the outcomes of patients undergoing TKA while using a GLP-1a medication.

Methods A search was conducted across MEDLINE/Pubmed, Cochrane, Google Scholar, Web of Science, and Embase databases. The search used a combination of keywords and Medical Subject Heading (MeSH) terms. Titles and abstracts were screened for eligibility. Full texts were then screened and included if they met eligibility criteria. Demographics and …

Thoracolumbar Fractures: Historical Systems And Advancements With The Ao Spine Classification, Barry Ting Sheen Kweh, Alex R. Vaccaro, Gregory D. Schroeder, Jose A. Canseco, Maximilian Reinhold, Mohamed M. Aly, Sebastian Bigdon, Mohammad El-Skarkawi, Richard J. Bransford, Andrei Fernandes Joaquim, Harvinder Singh Chhabra, Emiliano Vialle, Rishi M. Kanna, Charlotte Dandurand, Cumhur Öner, Jin Wee Tee

Rothman Institute Papers

Study Design: Systematic Review. Objective: To describe the historical classifications of thoracolumbar injuries and their evolution into the AO Spine Thoracolumbar Injury Classification System. Methods: A systematic review of MEDLINE, EMBASE and Cochrane Databases was performed in keeping with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: 445 articles were crystallized to 14 included studies. Simple categorization systems offered by Bohler or Watson-Jones merely identify fracture morphology. Holdsworth and Denis conveyed a sense of the stability of injuries by noting columns of stability, but still failed to take into consideration important factors such as neurological status or …

Intraosseous (Io) Analgesia Medication Administration In Orthopaedic Surgery: A Brief Review, Jenna Chrabolowski, Troy B. Puga, Abanoub Attallahm, Mckenna W. Box, John T. Riehl

North Texas GME Research Forum 2026

Introduction

Intraosseous (IO) analgesia is a novel strategy for pain control in orthopaedic surgery. This brief review aims to provide an overview of IO analgesia in orthopaedic surgery.

Methods

A search was conducted across seven databases. Titles and abstracts were screened followed by full-text review for inclusion criteria. Demographics and results were extracted from included articles.

Results

Ten studies met inclusion criteria and involved patients undergoing knee surgery and spinal surgery. IO lidocaine was shown to be effective for postoperative and intraprocedural pain control during vertebroplasty and kyphoplasty. IO morphine and IO NSAIDs were shown to be effective in reducing …

Outcomes After Orif Of Closed Bimalleolar And Trimalleolar Ankle Fractures In Patients With Autoimmune Disease, Mckenna Box, Troy B. Puga, Lachlan Anderson, Alyssa Kozlowski, John T. Riehl

North Texas GME Research Forum 2026

Background: Autoimmune disease is associated with chronic systemic inflammation, immunosuppressive therapy, and increased medical comorbidity, which may influence postoperative outcomes following fracture fixation. Data evaluating outcomes after ankle fracture surgery in this population remain limited. We hypothesized that autoimmune disease would be associated with higher postoperative complication rates following open reduction and internal fixation (ORIF) of closed ankle fractures.

Methods: We performed a retrospective cohort study using a multi-hospital dataset (2017-2025) to identify adult patients undergoing ORIF for closed bimalleolar or trimalleolar ankle fractures. Patients with autoimmune disease were propensity score matched 1:2 to patients without autoimmune disease based on …

Association Of Glp-1 Receptor Agonist Use With Postoperative Outcomes After Rotator Cuff Repair In Patients With Diabetes: A Propensity Score–Matched Analysis, Mckenna W. Box, Troy B. Puga, Hans Drawbert, Aysu Erdemir, John T. Riehl

North Texas GME Research Forum 2026

Background Diabetes impairs tendon healing after rotator cuff repair (RCR), with early postoperative poor glycemic control linked to a higher failure risk in studies. GLP-1 receptor agonists (GLP-1RAs) are increasingly used for glycemic control. Preclinical studies indicate that GLP-1RA may benefit rotator cuff healing through anti-inflammatory mechanisms as well. However, real-world data on the effects of GLP-1RAs on RCR outcomes remain incompletely understood.

Methods We conducted a retrospective cohort study using an institutional dataset (01/01/2016 to 09/30/2024) of adults aged 18-74 years with type 2 diabetes who underwent RCR. GLP-1RA exposure was established by home medication lists. Patients with autoimmune …

Biologic Versus Non-Biologic Immunosuppressant Use And Outcomes After Orif Of Closed Ankle Fractures: A Propensity-Matched Analysis, Mckenna W. Box, Troy B. Puga, Lachlan Anderson, Alyssa Kozlowski, John T. Riehl

North Texas GME Research Forum 2026

Background: The effect of biologic immunosuppressant therapy on postoperative outcomes following ankle fracture open reduction and internal fixation (ORIF) remains unclear, and concerns regarding infection and impaired healing often influence perioperative decision-making. We hypothesized that biologic immunosuppressant use would be associated with higher rates of postoperative complications following ORIF of closed ankle fractures compared with non-biologic immunosuppressant therapy.

Methods: We conducted a retrospective cohort study using a multi-hospital administrative dataset (2017-2025) to identify adult patients undergoing ORIF for closed bimalleolar or trimalleolar ankle fractures who were prescribed immunosuppressive therapy. Patients were categorized based on biologic versus non-biologic immunosuppressant use. A …

Handheld Magnet Screening Of External Fixator Components: A Laboratory Assessment Of Gross Ferromagnetism Relevant To Mri Safety, Troy B. Puga, Mckenna W. Box, Lyn D. Ward, John T. Riehl

North Texas GME Research Forum 2026

Introduction Much controversy remains regarding the ability of patients with an external fixator in place to undergo Magnetic Resonance Imaging (MRI). The main concern for radiology departments is that the external fixator system components can lead to adverse events due to interactions of the external fixator and the magnet of the MRI. However, there is no clear evidence to support these claims or theories in the current literature. Yet, MRI’s are denied daily across the country for patients having an external fixator in place. Numerous patients with an external fixator would likely benefit from an MRI to prevent delayed care, …

Efficacy And Outcomes Of Oxidized Regenerated Cellulose (Orc) In Total Joint Arthroplasty (Tja): A Systematic Review And Meta-Analysis, Jenna Chrabolowski, Troy B. Puga, Abanoub Attalah, Kyle P. O'Connor, Mckenna W. Box, Ashley Stovall, Michael Muncy, John T. Riehl

North Texas GME Research Forum 2026

Introduction Intraoperative and postoperative blood loss is a major concern and challenge for surgeons in total joint arthroplasty (TJA). Patients with large blood loss can develop postoperative anemia and associated complications. Novel hemostatic agents, such as oxidized regenerated cellulose (ORC) have grown in popularity as intraoperative hemostatic adjuncts. The aim of this systematic review and meta-analysis is to evaluate the efficacy of ORC for intraoperative and postoperative blood loss.

Methods A search was conducted across MEDLINE/Pubmed, Cochrane, Google Scholar, Web of Science, and Embase databases. Titles and abstracts were screened for eligibility for inclusion criteria. Full texts were screened and …

Opioid Prescribing Patterns Following Isolated Trigger Finger Release: A Single-Institution Quality Improvement Study, Brandalynn Mathis, Robert Garner, Cameron Sprong, Mark Gamadia, Alan Cornett, Steven Smith

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

A Chicken Model For Non-Invasive Diagnosis Of Infant Developmental Dysplasia Of The Hip (Ddh) Using Acoustic Transmission Measurements, Aliza Shah

Honors Undergraduate Theses

Developmental dysplasia of the hip (DDH) is a condition characterized by abnormal development and stability of the hip joint. In a healthy infant, the femoral head (ball) fits securely within the acetabulum (socket of the pelvis), allowing for proper joint function. In DDH, the relationship is disrupted, ranging from mild acetabular dysplasia to partial (subluxation) or complete dislocation of the femoral head. This condition represents a range of structural abnormalities that develop during early growth. The integrity of the hip joint is essential for physical mobility, and disruption of this structure can lead to significant functional impairment. DDH may result …

Model For Calculating Impact Force For Individualized Hip Fracture Prediction During A Fall, Alisha Agarwal, Daniel Kargilis, Nishtha Gupta, Michael Chang, Rui Feng, Gregory Chang, Chamith S. Rajapakse

Student Papers, Posters & Projects

Osteoporotic-related weakening of bone is a common cause of hip fractures. The standard of care for the diagnosis and management of osteoporosis is the dual-energy x-ray absorptiometry bone mineral density T-scores. Many individuals considered nonosteoporotic, however, still sustain fractures since these tools do not incorporate vital bone parameters and subject-specific characteristics. The purpose of this work was to (1) develop a simple analytical model for estimating the force exerted on the femur during a fall (i.e., impact force) based on measurable patient metrics and (2) define a quantifiable fracture risk index by comparing finite-element-derived bone strength and impact force, which …

The Associations Between Meniscus Tear Location And The Prevalence And Severity Of Cartilage Wear In Different Knee Compartments Using An Arthroscopic Grading System, Tara Korbal, Claudia Leonardi, Amy Bronstone, Vinod Dasa

School of Medicine Faculty Publications

Introduction: Meniscus tears are associated with progressive cartilage degeneration and worsening osteoarthritis. Although several previous studies have explored the relationship between meniscus tears and cartilage damage, few have examined the relationship between tear location and cartilage wear in all knee compartments using an arthroscopic grading system. Objectives: Evaluate the association between meniscus tear location and the prevalence and severity of high-grade cartilage wear in knee compartments. Methods: A total of 210 patients were categorized into groups based on meniscus tear location: medial meniscus tear (MMT, n = 106), lateral meniscus tear (LMT, n = 41), and medial-lateral meniscus tear (MLMT, …

Comparing Lower Extremity Kinematics Using Trazer And Inertial Motion Capture Systems, Gabriella Juoza-Clark Spt, Joellen Carter Spt, Nikki Stam Spt, Kevin Robinson Pt, Dsc, Ocs

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: This study assessed the validity of a non-immersive body motion tracking system (TRAZER) as an alternative to using Inertial Measurement Units (IMU)-based motion capture (MyoMotion) for lower extremity kinematic analysis. Methods: Twenty healthy participants (10 females, 10 males) with a mean age of 24.03 years (range: 20-33 years) and a mean BMI of 25.15 kg/m² (range: 18.45-32.23 kg/m²) performed double and single-leg squats. Data Analysis: Kinematic data from TRAZER and MyoMotion IMUs were compared using a mixed two-way ANOVA. Results: No significant differences were observed in knee flexion data across all movements (p > 0.05) and knee abduction during the …

Utilizing Femoral Metaphyseal Sleeves In Primary Total Knee Arthroplasty For Post-Traumatic Osteoarthritis: A Case Report, Zachary Sukin, Adam Dentinger, Jeremiah Earl

HCA Healthcare Journal of Medicine

Background

Total knee arthroplasty in younger patients presents a heightened risk of postoperative complications and implant failures compared to older populations, particularly in those with posttraumatic arthritis. These challenges necessitate careful consideration and specialized approaches to optimize the outcomes in this patient demographic.

Case Presentation

A 43-year-old man presented with left knee pain resulting from a traumatic lawn mower injury, causing an intraarticular distal femur, at the age of 6. The injury led to a limb-length discrepancy for which he underwent 2 limb-lengthening procedures in his early 20s. Radiographs demonstrated advanced posttraumatic osteoarthritis, and the patient elected to proceed with …

Cmc Arthroplasty For Treatment Of The Painful And Arthritic Thumb: A Review Of Surgical Treatment Options With Preferred Technique, Jon E. Hammarstedt, Yehuda A. Masturov, Sebastian D. Arango, Jacob Zeitlin, Samuel H. Payne, Mark S. Rekant

Department of Medicine Faculty Papers

Arthritis of the first carpometacarpal joint is a prevalent and often disabling condition for many older adults. The diagnosis is typically established through a comprehensive patient history, physical examination, and confirmatory radiographs. Nonsurgical management with splinting and anti-inflammatory medication has demonstrated effectiveness. Several surgical options have proven effectiveness for those who fail nonsurgical management. Surgical options include silicone implantation, resection arthroplasty, tendon interposition, ligament reconstruction, denervation, and joint implant arthroplasty. In the following review, we will elaborate upon the array of therapeutic approaches, culminating in the delineation of our preferred method.